| NPI | 1487800173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A11661) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV DO1597) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2012-11-19 |